Flamingo Insurance Agency

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Flamingo Insurance Agency
Flamingo Insurance
Hialeah Office
2189 West 60 Street
Suite 202
Hialeah, Fl 33016
305-828-4847

Coral Gables Office
124 Madeira Avenue
Coral Gables, FL
305-448-2887

Toll Free
1-888-839-7383

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Commercial Lines Insurance Quote Form

Customer Information
Corporation Name
DBA Name
FEIN #
Location Address
Mailing Address
City
State
Zip Code
Contact Name* Contact Phone* Email*
Description of Operations
Other
Company Information
Years of Experience Prior Insurance coverage
Years Established Expiration Date
Number of Employees Coverages
Payroll Total Claims
Sales Total    
Structure (Building) Information
Year Built Owned/Leased?
Square Feet Alarm System
Year Updated Sprinkler System
Roof Type Glass/Sign
Construction Type Misc.
No. of Floors    
Coverage Information
Building Liability
Contents Products
Business Income Per injury
Misc. Fire Legal
Theft Deductible Medical Pay
Wind Deductible Deductible
Coverage
Value
Percent
   
Other Information
List other relevant information:  

 

 
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